Single Aortic Clamp versus Partial Occluding Clamp Technique for Cerebral Protection During Coronary Artery Bypass: A Randomized Prospective Trial
Bibliographic record
Abstract
UNLABELLED: Single aortic clamp (SAC) versus partial occluding clamp (POC) technique for the construction of proximal anastomosis has been suggested to provide better cerebral protection during coronary artery bypass grafting (CABG). The aim of this study was to assess this hypothesis in a prospective randomized trial. METHODS: Two hundred sixty-eight consecutive patients underwent CABG at a single institution. All patients were randomized to either SAC (Group S) or POC (Group P) for the construction of the proximal anastomosis. Myocardial protection consisted of multidose antegrade cold blood cardioplegia with topical cooling. The operations were performed using standard cardiopulmonary bypass support and moderate systemic hypothermia (29 to 32 degrees C). The incidences of neurological events, perioperative myocardial infarction (MI), and mortality were prospectively evaluated. RESULTS: The two groups were similar in mean age, gender, urgency of operation, and number of bypasses. Group S patients had a significantly longer cross-clamp (61 +/- 21 minutes [S] vs 44 +/- 13.8 minutes [P], p < 0.05) and bypass times (85 +/- 25 minutes [S] vs 74 +/- 19.7 minutes [P], p < 0.05). There were no differences in the number of perioperative MIs (Group S = 3 [2.3%]; Group P = 2 [1.5%], p = 0.50) or mortality (Group S = 2 [1.5%]; Group P = 3 [2.2%], p = 0.50). Two patients randomized to POC were switched to SAC intraoperatively because of severe calcification of the ascending aorta. In Group P, there were two strokes (1.5%) and two (1.5%) postoperative confusions versus none in Group S (relative risk = 2.0, p < 0.05, respectively). CONCLUSION: The SAC technique improved cerebral protection without any adverse effect on myocardial protection and postoperative outcome in patients undergoing CABG.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".